Danielle Pitchford
Topeka,Kansas
Summary
Registered Nurse (RN) with most recent experience in psychiatric/mental health nursing pediatric office and utilization review/payor denial for a large hospital. In addition, I am a clinical instructor at Washburn University School of Nursing.
I have developed strong psychiatric evaluation and treatment-planning skills through previous and current career experience.
Compassionate Registered Mental Health Nurse (with Adults, Children, Adolescents and Geriatrics) with background in crisis intervention, patient assessment and treatment planning. Proficient in collaborating with interdisciplinary teams to ensure optimal patient care. Strong communication skills coupled with demonstrated ability in patient advocacy and education. Contribute positively to patient outcomes through application of nursing best practices and commitment to ongoing professional development.
I have a great understanding of the insurance system as it pertains to hospitalization and experience with the appeal and denial process, including proficiency utilizing MCG criteria.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Adjunct Clinical Instructor
Washburn University School of Nursing
02.2024 - Current
- Provide oversite and education to Nursing Students in their mental health rotation in a variety of settings including the local hospital and community mental health center
- Reviewing content, and providing education to advance their knowledge in the mental health field
Registered Nurse (Utilization Review Specialist/Payor Denial RN)
Stormont-Vail HealthCare
Topeka, KS
09.2017 - Current
- Company Overview: Clinical Performance Department
- Serve as a Utilization Review Specialist in which I complete Bed Review’s on potential admissions currently placed in the Emergency Department, as well as providing thorough chart reviews and utilizing the Milliman Criteria Guidelines to document how a patient meets criteria for hospitalization
- This is done on all admitted patients, whether they come from the Emergency Department, another facility or home
- I do a majority of my work in Payor Denial on reviewing denied claims and complete write-up’s to send back to the insurance companies
- Clinical Performance Department
Outpatient Registered Nurse
Family Service and Guidance Center
06.2014 - Current
- Work as an outpatient nurse where I refill medications per protocol and provider direction, communicate information to/from providers to/from parents/guardians
- Patient education from providers to parents by phone, help in developing policies for the medical department regarding scheduling department process and refills
Registered Nurse
Stormont-Vail HealthCare
Topeka, KS
08.2008 - 09.2017
- Company Overview: (Inpatient Psychiatry)
- Served as an RN on the Children/Adolescent Psychiatric Inpatient Unit, Geriatric Psychiatric and Adult Units
- Provided care to patients with a variety of mental illness - including but not limited to medication administration and education, group activity sessions on a variety of treatment topics related to patient needs
- Working with a multi-disciplinary team of Psychiatrists, APRNs, LPNs, RNs, Patient Care Technicians and Mental Health Technicians
- During some of my years I was a Charge Nurse and Nurse Manager in which I supervised RN’s, LPN’s, PCT’s and LMHT’s in providing safe, high quality care to patients
- I helped complete monthly schedules, educating new staff and doing yearly staff reviews
- (Inpatient Psychiatry)
Registered Nurse
Stormont-Vail HealthCare
Topeka, KS
06.2008 - 08.2008
- Company Overview: (Medical-Surgical Unit)
- Served as RN on the Medical/Telemetry Unit
- Provided nursing care to Adult patients with a variety of medical issues
- Worked with a multidisciplinary team to provide effective, ethical patient care
- (Medical-Surgical Unit)
Registered Nurse
Fairbanks Memorial Hospital
Fairbanks, AK
02.2008 - 06.2008
- Served as RN in the Adult Inpatient Psychiatric Unit
- Worked with an interdisciplinary team of psychiatrists, LPNs and RNs
- Actively participated in the development and implementation of individual treatment plans for patients with a broad range of mental health issues
- Ensured that doctors’ orders were effectively carried out
Education
Bachelor of Science - Nursing
Washburn University - School of Nursing
Topeka, KS12.2007
MSN - Nursing Education
Baker University School of Nursing
Topeka, KSSkills
- Teaching proficiency
- Clinical supervision
- Utilization review
- Case evaluation
- Multidisciplinary approach
- Quality improvement
- HIPAA compliance
- Vitals monitoring
- Compassionate and caring
- Clinical documentation
- Team building
- Teamwork
- CPR/AED
- Microsoft office
- Team collaboration
- Strong clinical judgment
- Data entry proficiency
- Effective communication
- Medical terminology
- Problem-solving capacity
- Documentation expertise
- Strong analytical skills
- Continuous learning mindset
- Technical writing
- Written communication
- Adaptability
- Multi-tasking
- Computer proficiency
- Denied claims identification
- Insurance plan verification
- Task prioritization
- Appointment scheduling
Accomplishments
- Completed training in Customer Service Training and Non-Violent Crisis Intervention Management.
- Trained in MAB (Managing Aggressive Behavior)
- Collecting and Monitoring Quality Improvement Data
- Chosen to and attended the Annual Nursing Magnet Conference in Phoenix, Arizona in October 2010.
- Distinguished Staff Award from Family Service and Guidance Center in 2016
Professionalreferences
- Eric Atwood, Previous Medical Director at Family Service & Guidance Center, 785-806-0287
- Charles Millhuff, Current Chief Medical Officer at Family Service & Guidance Center, 785-213-3030
- Lana Holcom, Preceptor for Senior Capstone in College / Family Friend, 785-213-0686
Certification
- Registered Nurse - State of Kansas (In the process of upgrading license to Multi-State)
Timeline
Adjunct Clinical Instructor
Washburn University School of Nursing
02.2024 - Current
Registered Nurse (Utilization Review Specialist/Payor Denial RN)
Stormont-Vail HealthCare
09.2017 - Current
Outpatient Registered Nurse
Family Service and Guidance Center
06.2014 - Current
Registered Nurse
Stormont-Vail HealthCare
08.2008 - 09.2017
Registered Nurse
Stormont-Vail HealthCare
06.2008 - 08.2008
Registered Nurse
Fairbanks Memorial Hospital
02.2008 - 06.2008
Bachelor of Science - Nursing
Washburn University - School of Nursing
MSN - Nursing Education
Baker University School of Nursing
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